Citing Low Staff, Medicare Lowers Ratings for 1,400 Nursing Homes

Medicare recently lowered the overall ratings of almost one-fourth of the country’s nursing homes due to insufficient staff levels. The move comes after Medicare adopted a new, objective measurement for staffing nursing homes. Previously, Medicare relied on unverifiable data submitted by the nursing homes. Medicare ratings, which can range between one and five stars, are provided for several categories of nursing home care, such as its rating of pressure ulcers or slip-and-falls, along with an overall rating for the nursing home. Medicare now gives the lowest rating, a single star, to 1,387 nursing homes across the country, according to The New York Times.

Medicare requires all nursing homes to have a licensed nurse working at all times and a registered nurse working at least eight hours every day. The payroll data submitted to Medicare by the nursing homes show that the registered nurse requirement produced the majority of compliance problems. Registered nurses, who have the highest level of training and education requirements, are typically able to provide medical services, such as diagnosing illnesses or prescribing medicine.

While Medicare has not changed the number of nursing home nurses required, the government’s healthcare agency has retooled the process for reporting staff. Previously, a nursing home would provide a “random sample of dates” to the nursing home inspector and would be judged on whether the staffing levels on those certain days satisfied federal requirements. In response to criticism that this method was inaccurate and prone to manipulation by the nursing homes, the Affordable Care Act required Medicare to collect yearly payroll data from the nursing homes. Almost a decade becoming law, Medicare finally rolled out the new system earlier this year.

According to Medicaid, a nursing home would see their score in this category reduced if staffing fell below federal requirements more than seven days in a three-month period. Nursing homes with a one-star rating in this category failed to show adequate staffing levels for “a high number of days” during the same period. While some nursing homes complained that the new system does not accurately include salaried employees or some hourly employees working overtime, Medicare said nursing homes have been on notice about the changes since 2015. Other nursing homes attributed their lowered score to difficulties in hiring and retaining nurses. Regardless of the cause, nursing homes should care enough about their senior citizens and satisfy these relatively minimal staffing requirements.